Intentional Dexketoprofen Overdose During Pregnancy: Maternal and Fetal Outcomes in Three Cases

Dexketoprofen trometamol is a widely used short-acting nonsteroidal anti-inflammatory drug. Despite its widespread clinical use, pregnancy-specific safety data for dexketoprofen as an individual agent are lacking, and no previous report has described maternal or fetal outcomes following overdose in pregnant women.

We present three cases of intentional dexketoprofen overdose during pregnancy. Case 1 involved a 33-year-old woman at 8 weeks of gestation who ingested dexketoprofen with ibuprofen, pseudoephedrine, and cefuroxime; she delivered a healthy male infant at 37 weeks with no congenital anomalies on follow-up. Case 2 involved a 36-year-old woman at 17 weeks who ingested dexketoprofen with ergotamine tartrate, mecloxamine, caffeine, and paracetamol; she experienced a spontaneous abortion at 20 weeks, complicated by cyst rupture requiring hysterectomy. Case 3 involved a 29-year-old woman at 6 weeks who ingested dexketoprofen, paracetamol, and chlorpheniramine, and underwent elective termination at 10 weeks.

The three cases demonstrated heterogeneous pregnancy outcomes. No congenital anomalies were identified in the single evaluable live-born infant. Multiple co-ingested agents substantially complicate causal attribution, most notably ergotamine tartrate in Case 2. The limited case number and outcome heterogeneity preclude identification of a consistent pattern of fetal adverse effects or definitive conclusions regarding fetal risk. All overdoses were intentional, underscoring the importance of integrating psychiatric assessment into toxicological management during pregnancy. These cases represent the first available observational data on maternal and fetal outcomes following intentional dexketoprofen overdose in pregnancy, highlighting the need for a multidisciplinary approach in this clinical setting.